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Researchers quantify benefits of minimally invasive removal of hard-to-reach tumors
Date:4/1/2010

s says, follows natural anatomical corridors and causes less disruption of nasal tissues. This approach, as the new study reveals, also holds benefits related to complete tumor removal, which is important for the patient's quality of life.

Removing an entire pituitary macroadenoma can be difficult because the tumor's growth pattern can cause it to extend through the sinus corridor, which is out of the surgeon's view.

Surgeons can ensure that the entire tumor has been removed if their hospital operating room is equipped with a technology known as intraoperative MRI, or ioMRI. The surgery-prolonging technology enables surgeons to take MRI scans while the patient is still under anesthesia and on the operating table. The UC Neuroscience Institute at University Hospital has had ioMRI since 1999, but the expensive technology is not available at most hospitals.

An endoscopic approach, by contrast, allows the surgeon to check for remaining tumor with "intrasellar endoscopy." Using a tiny, sophisticated camera on an angled endoscope, the surgeon can peer around bends and into crevasses to identify any remaining tumor. "The endoscopic approach holds the potential for less invasive treatment for all patients and more complete tumor resections for individuals treated in hospitals without access to intraoperative MRI," Theodosopoulos says.

During the retrospective study at University Hospital, the team analyzed surgical outcomes of 27 consecutive patients between 2005 and 2007 who had undergone endoscopic removal of pituitary macroadenomas. The search for unexpected residual tumor was conducted two ways in all patients: first with the tiny endoscopic camera (intrasellar endoscopy) and then with intraoperative MRI.

Following the initial endoscopic tumor removal, intrasellar endoscopy revealed that 23 of the 27 patients (85 percent) had no unexpected residual tumor. Surgeons were able to safely perform additional surgery on three of
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Contact: Cindy Starr
cstarr@mayfieldclinic.com
513-558-3505
University of Cincinnati Academic Health Center
Source:Eurekalert

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